Provider Demographics
NPI:1376115469
Name:GONZALEZ, ANA CECILIA (NP-C)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:CECILIA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3949 NW 85TH TER APT H
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64154-3782
Mailing Address - Country:US
Mailing Address - Phone:816-686-3429
Mailing Address - Fax:
Practice Address - Street 1:3949 NW 85TH TER APT H
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-3782
Practice Address - Country:US
Practice Address - Phone:816-686-3429
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-16
Last Update Date:2021-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021021275363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily